MICHAEL AMBROSE MD
NPI 1538398680
Internal Medicine in Mount Vernon, IL

Q: What is Michael Ambrose's NPI number?

The NPI number for Michael Ambrose is 1538398680. It was assigned to this individual provider in the NPPES registry on July 10, 2009.

Q: What is Michael Ambrose's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Michael Ambrose was last updated on March 25, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 10, 2009PECOS Enrolled

605 N 12TH ST, MOUNT VERNON, IL 62864(618) 241-2212(618) 241-2508 Get Directions Write a Review

NPPES record last updated: March 25, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 25, 2021, Jan 29, 2021, Jul 18, 2018 (3 updates tracked since 2018).

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About Michael Ambrose Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MICHAEL AMBROSE MD (NPI 1538398680) is an individual internal medicine provider in Mount Vernon, Illinois, licensed in Illinois (036128279) and active in the NPI registry since July 2009. He is enrolled in Medicare PECOS and maintains a secondary practice location in Mount Vernon.

NPPES Registry Identity

NPI1538398680

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameMICHAEL AMBROSECredential: MD

Location Address605 N 12TH STMount Vernon, IL 62864

Mailing Address5036 N Illinois St Ste 1Fairview Heights, IL 62208-3418 · (618) 671-6800

Phone(618) 241-2212

Fax(618) 241-2508

Sole ProprietorNo

Enumeration DateJuly 10, 2009

Last NPPES UpdateMarch 25, 20213 updates tracked since enumeration

NPPES CertifiedMarch 25, 2021

✔ NPI 1538398680 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in IL · 036128279

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedChiropractorTaxonomy 111N00000X · License 038010043 (IL)

Also ListedHospitalistTaxonomy 208M00000X · License 036128279 (IL)

605 N 12TH ST, Mount Vernon, IL 62864

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Secondary Practice Location 1

Location 1605 N 12th StMount Vernon, IL 62864-2857 · Phone (618) 241-2212 · Fax (618) 241-2508

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Michael Ambrose Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Michael Ambrose reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Granite City Hospitalist Services LLC

42 mi

Hospitalist

2250 N ILLINOIS AVE
Carbondale, IL 62901

Reassigned Medicare billing, Illinois enrollment
88 clinicians in this Medicare group

NPI 1669926424 (618) 833-1691

Midwest Emergency Anderson Health, Inc

68 mi

Emergency Medicine

400 N CALDWELL ST
Staunton, IL 62088

Reassigned Medicare billing, Illinois enrollment
121 clinicians in this Medicare group

NPI 1710647615 (618) 635-2200

Cogent Healthcare Of Missouri, Inc

87 mi

Critical Care Medicine

1015 BOWLES AVE
Fenton, MO 63026

Reassigned Medicare billing, Missouri enrollment
255 clinicians in this Medicare group

NPI 1780961599 (615) 377-5600

Sound Physicians Of Illinois, LLC

88 mi

Hospitalist

12303 DE PAUL DR
Bridgeton, MO 63044

Reassigned Medicare billing, Missouri enrollment
301 clinicians in this Medicare group

NPI 1043598865 (314) 344-6000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62864 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

54%265 patients3/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

4 suppliers12 claims12 services$70.05 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier12 claims12 services$215.65 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTIE TURNER P.T.

Physical Therapist